Tear of the superior labrum (SLAP Tear)             Repair of the liberal tear with absorbable anchors

Shoulder Labral Tears

The shoulder labrum is a rim of thickened tissue that surrounds the bony rim of the shoulder socket. The labrum is important because it functions as an anchoring point for the supportive ligaments surrounding the shoulder joint. Labral tears are common sports injuries in which the labrum is partially or completely detached from the underlying bone. Symptoms of labral tears include clicking, pain and a feeling of instability in the shoulder joint with certain movements. The confirmatory test is called a gadolinium contrast MRI arthrogram in which a small amount of contrast in injected into the shoulder joint prior to the MRI scan.  The contrast is important because it allows clear delineation between the labrum and the underlying bone.  Treatment of labral tears focuses on surgical reattachment of the torn labral fragment back to the bone using bone anchors and stitches.  The procedure is done as an outpatient using minimally invasive arthroscopic techniques. Rehabilitation takes roughly 3 months and most patients have excellent return of function after repair.

Anterior labral tears are the result of a partial dislocation in which the supportive ligaments are avulsed (torn away) from the bone along with a sleeve of labral tissue.  Patients with this type of tear usually complain of a feeling of laxity or instability in their shoulder when their arm is in a throwing position.  Superior labral tears (see above figures) are also referred to as SLAP tears in which the achor of the biceps tendon is avulsed from the upper portion of the glenoid. Patients with this type of tear complain of clicking in their shoulder and pain with arm rotation.

Both types of labral tears are treated similarly.  Using an arthrostomy ( a small fiberoptic device about the diameter of a #2 pencil) I reattach the torn portion of labrum back to the underlying bone using one way suture anchors (see above figure).  The surgery takes roughly 1 to 1.5 hours and is done as an outpatient.  Most patients regain shoulder motion over a roughly 3 month time frame but I don't allow patients to do strenuous lifting or overhead throwing for about 6 months.  A progressive therapy program is critical in achieving a good outcome.